Most importantly: if you are feeling threatened right now, call 911 or the National Domestic Violence hotline in the US at 800-799-SAFE [1-800-799-7233; or 1-800-787-3224 (TTY)].

It is important to remember that, if someone threatens you, it is NOT your fault. You deserve to be treated with respect and to be safe. Often, women who have been abused have been humiliated to the point that they believe that they deserve whatever abuse comes their way. This is NEVER true.

"I will no longer take responsibility for the abuse I've received from the people I loved.

Women, HIV, and Violence

According to the World Health Organization (WHO), violence against women (VAW) is a "global health problem of epidemic proportions." Violence against women refers to acts of violence directed toward women simply because they are women. These acts can include forms of physical, emotional, and sexual harm -- or threats of harm. Often, women do not consider these harmful acts as violence, either because the acts are considered to be normal in their society, or because they occur so often that they seem normal.

Violence against women is extremely common, affecting as many as seven in ten women in some countries. The majority of women suffer violence at the hands of their husbands, intimate partners, or other men they know. Women can also experience violence at the hands of their female partners, as this type of violence is just as common in same-sex relationships as in heterosexual relationships. Among women of reproductive age, "acts of violence cause more death and disability than cancer, malaria, traffic accidents and war combined. (UN Women)."

This violence has horrible consequences, both for women and their communities. The WHO reports that more than one-third of women worldwide who are murdered are killed by their intimate partners. Unwanted pregnancies, especially in adolescent girls, are more likely to result in low birth weight babies and pregnancy-related injuries to young mothers. Women who experience intimate partner violence are about twice as likely to experience both depression and alcohol abuse. The damaging effects that this violence has on women's emotional and physical health also create lasting consequences for the children and family members who depend on them.

In March 2012, US President Obama established an interagency federal working group to look at how HIV/AIDS, violence against women and girls, and gender-based health disparities connect together, or intersect. This working group examined how violence against women and girls affects their likelihood of getting HIV and how they live with HIV. In the US, more than one in three women report having experienced rape, physical violence, or stalking in their lifetimes. Moreover, women living with HIV (HIV+) are much more likely to have experienced violent relationships (e.g., intimate partner violence) than HIV-negative women.

In September 2013, the working group released a report of federal policy recommendations and action steps to address the intersection of HIV and violence against women. These include:

increasing screening for intimate partner violence and HIV among women

improving outcomes for HIV+ women by addressing history of violence and trauma

addressing factors that add to increased risk of violence among women living with HIV

There are several ways in which violence and HIV are connected for women. Women who are abused or fear a violent response may not be comfortable asking their partner to use protection during sex. Similarly, women in abusive relationships may not be comfortable saying no to sex if their abusive partner refuses to use protection when asked. Lastly, forced sex acts can cause cuts, scrapes, or tears, that make it easier for HIV to enter the body. All of these can put women at higher risk for HIV, and make living with HIV more difficult.

Many women with HIV have a history of being physically or sexually abused before they found out about their HIV status. Several studies have shown that women with a history of physical and/or sexual abuse are more likely to become HIV+, especially if that abuse first started during childhood years. Childhood abuse is closely linked with later drug use, having multiple sexual partners, being with a male partner who is at a higher risk of HIV infection, and exchanging sex for drugs, money, or shelter. If a woman uses drugs, alcohol, or sex to escape the pain of prior abuse, she may be at increased risk of getting infected due to sharing needles and having unprotected sex. All of these factors place a woman who has been abused at a higher risk for getting HIV.

Many women may be at risk of abuse or violence because they tell their partner or the person they live with about their HIV status. One study revealed that over one in four women with HIV had been physically harmed since their HIV diagnosis. Therefore, it is important to disclose your HIV status safely (see below). Among women living with HIV, studies have also shown that trauma and violence are associated with poorer health as a result of reduced HIV drug use and decreased adherence. For more information on the connection between trauma and HIV among women, see our article on Trauma and HIV.

Violence occurs more often in relationships in which there is a difference in power. Women living with people who are larger or stronger than they are may feel physically afraid. Also, women usually earn less money than men and are more likely to be financially dependent on others. If the person a woman lives with is the one who pays the bills and provides her with a home, then the woman may feel afraid, less independent, and less able to get away from her abuser.

What Is Domestic or Intimate Partner Violence?

Domestic violence occurs when a person you are dating, living with, or married to is repeatedly harmful or threatening to you - physically, sexually, verbally, emotionally, or financially. The person doing these things will often do them to gain or keep power and control. "Intimate partner violence" is another term used to describe violence in which a current or former partner or spouse physically, sexually, or psychologically harms you.

Intimate partner violence can happen to anyone. It affects people regardless of age, race, gender, sexual orientation, education level, financial situation, or marital status. It is important to learn about how abuse happens, how to identify it, and how to end it or get away from it. If you are feeling threatened right now, call 911 in the US or the National Domestic Violence hotline in the US at 800-799-SAFE [1-800-799-7233; or 1-800-787-3224 (TTY)].

It is important to remember that, if someone threatens you, it is NOT your fault. You deserve to be treated with respect and to be safe. Often, women who have been abused have been humiliated to the point that they believe that they deserve whatever abuse comes their way. This is NEVER true.

Intimate partner or domestic violence can take many forms. These include:

Verbal abuse (using words to put someone down or make them feel bad), threats, constant blame or criticism; all of these are emotionally abusive

Isolation -- controlling what someone does, where she goes, what she wears, what she reads, etc.

Using threats to pressure or force (e.g., threatening suicide, reporting someone to immigration, threatening to take children away)

Using male privilege to treat her like a servant, act like he is the 'king of the castle,' etc.

Domestic violence often begins with threats or emotional abuse. While these harmful words or actions may or may not lead to actual physical harm, they can still be very upsetting and scary, and leave long-term emotional scars.

While most domestic or intimate partner violence involves men assaulting women, it can also involve men assaulting their male partners, or women assaulting their male or female partners. Studies have shown that intimate partner violence can happen as often in same sex couples as it can in heterosexual couples.

This article was provided by The Well Project. Visit The Well Project's Web site to learn more about their resources and initiatives for women living with HIV. The Well Project shares its content with TheBody.com to ensure all people have access to the highest quality treatment information available. The Well Project receives no advertising revenue from TheBody.com or the advertisers on this site. No advertiser on this site has any editorial input into The Well Project's content.

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